offlabel

offlabel

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All Content by offlabel

  1. when is the best time to do ECG for dialysis patient

    offlabel replied to uae808's topic in Dialysis, Renal, Urology

    You're not looking for electrolyte mediated changes in the T and R waves. You're looking for evidence of myocardial damage as a comorbidity of

  2. Dealing with a cocky tech?

    offlabel replied to amzyRN's topic in Emergency

    ... as the new person in the department and yes I'm relatively new, less than a year in the ED.... Operative phrase here. Focus on yourself right now. If there is an issue with this person, you're...

  3. Propofol Dosing in ER

    offlabel replied to rhkenji's topic in Emergency

    All the above + check and make sure the IV is still in after all of the

  4. Support Planned Parenthood Today!

    offlabel replied to elkpark's topic in Activism, Healthcare

    What is always forgotten in this conflict is that both sides have the best of intentions for women and girls that have a crisis pregnancy. No one wants anything bad to happen to her, just the very...

  5. Dry chem extinguisher effects

    offlabel replied to FFMDC's topic in Burn

    Really good question, considering these types of fire extinguishers are pretty much everywhere and would be a logical tool to put out someone that is on fire or physically in burning material. There...

  6. Acetaminophen use, liver damage, and ICU

    offlabel replied to FerrousVirago's topic in Critical Care

    Finishing of the liver with Tylenol when muscle paralysis will achieve the same end doesn't seem to be in the best interests of the patient. Restoring neuro function just to have the patient bleed to...

  7. Whiny surgeons and drama-queen nurses

    offlabel replied to firemedic12's topic in MICU, SICU

    There are nurses that get picked on and nurses that don't. Sounds like you know the way not to get picked

  8. when is the best time to do ECG for dialysis patient

    offlabel replied to uae808's topic in Dialysis, Renal, Urology

    I would think it doesn't matter. The point isn't to demonstrate pre or post dialysis EKG changes. People with end stage renal disease are at very high risk for cardiovascular comorbidities and the EKG...

  9. Acetaminophen use, liver damage, and ICU

    offlabel replied to FerrousVirago's topic in Critical Care

    Part of routine hypothermia protocol maybe? Tylenol would be almost be universally avoided in this patient if he didn't have a heart attack, let alone with severely impaired liver function....

  10. tips and tricks for difficult IV starts?

    offlabel replied to amzyRN's topic in Emergency

    This tip has been around for 30 or more years and it has to be done correctly to work. The distal tourniquet has to be both venous and arterial, stopping all flow distal to it. Put it on first. The...

  11. Case Review: 77 y.o. with acute respiratory failure previously discharged with PNA

    offlabel replied to Catticus11's topic in Critical Care

    1. Why an open lung biopsy? Because of all of the points you bring up in #2. Tissue bx will point to the actual problem. 2. There was a debate between the physicians whether this was ARDs, Cancer,...

  12. Happy CRNA Week, what did you get?

    offlabel replied to Bluebolt's topic in Certified Registered Nurse Anesthetist, CRNA

    First off, I said "grump alert"...Secondly, what I object to is being reduced to pens, mugs and cakes when I honestly don't need to remind anyone of who I am or what I do. I regret that so many feel...

  13. Neuro ICU vs. Transplant ICU for CRNA School

    offlabel replied to Chelse.RN's topic in Critical Care

    If by transplant, you mean heart/lung and liver, then definitely that. If not, toss

  14. Do you huddle?

    offlabel replied to SerenaBeana's topic in Emergency

    We used to get beers after work...not the same

  15. Calcium Chloride vs Calcium Gluconate

    offlabel replied to Manurse715's topic in CCU, Coronary, Cardiac

    Excellent post, for its brevity and accuracy. I'd just refine it by saying that while you may be correct in pointing out that "all" postop heart (cardiopulmonary bypass) patients may be coagulopathic,...

  16. Happy CRNA Week, what did you get?

    offlabel replied to Bluebolt's topic in Certified Registered Nurse Anesthetist, CRNA

  17. Happy CRNA Week, what did you get?

    offlabel replied to Bluebolt's topic in Certified Registered Nurse Anesthetist, CRNA

    OK, I'll buy that. If the CRNA's are buying lunch for the crew during CRNA week, that is legit,

  18. Happy CRNA Week, what did you get?

    offlabel replied to Bluebolt's topic in Certified Registered Nurse Anesthetist, CRNA

    Grump alert...house keepers and CNA's get "weeks". For folks like that, what they actually do day to day and what they are paid are pretty discordant and they're pretty much invisible and for the most...

  19. Combined use of nicardapine and esmolol drips for aortic dissection

    offlabel replied to R8T3D_RN's topic in Emergency

    Agree with respect to delays because of fear based out of ignorance. That said, these patients are most usually unable to respond to MAP lowering measures with reflex tachycardia. HR's over low 100's...

  20. Combined use of nicardapine and esmolol drips for aortic dissection

    offlabel replied to R8T3D_RN's topic in Emergency

    Just a point of order here. Ascending and other thoracic aneurysms dissect. Abdominal aneurysms rupture. There is a difference and although it might be just semantics for room staff in the OR/ICU, it...

  21. IV medication that can not run fast

    offlabel replied to kinmei's topic in Medical-Surgical

    CRNA here...Potassium in a peripheral IV in an awake patient really hurts. I'll give 10 meq over 15-20 minutes routinely through a central line, recheck K+ and repeat if necessary. I also bolus 4 mg...

  22. Inequalities of Health Care - Celebrating Martin Luther King, Jr Day

    offlabel replied to traumaRUs's topic in General Nursing

    Anyone that has a sincere interest (everyone?) in the message of Dr. King has the obligation, at least, to read his "letter from a Birmingham Jail". Here it is... Letter from a Birmingham Jail [King,...

  23. RN to PA

    offlabel replied to RNPA93's topic in Advanced Practice

    It's how it's done in anesthesia. Not fool proof, but, by and large, it

  24. RN to PA

    offlabel replied to RNPA93's topic in Advanced Practice

    "Autonomy" is in the eye of the beholder. Sure, the PA running the critical access ER an hour away from the mother ship is practicing under a physician, but that physician is at the mother ship and is...

  25. OR Job Choice Help!

    offlabel replied to mchase's topic in Operating Room

    It's pretty close, but I always found that neuro/spinal/ortho had a more toxic culture than CT surgery. Just me. I'm sure there are those that have found the opposite. CT is more specialized however...